REFUGEE AND INTERNATIONAL HEALTH PROGRAM
Minnesota Civil Surgeons List
Understanding the Role of the Civil Surgeon and Adjustment of Status for Refugees
Immigrants who have been in the U.S. for one year may complete medical evaluations to adjust their status and obtain a Green Card. The
medical evaluation requirements are different for refugees and immigrants, so it is important to first determine whether the individual is
designated as a refugee or an immigrant. In most cases your patient will know their designation. If they do not know, ask to see their I-94
card. As a general rule, a refugee will have the word "refugee" printed on their I-94 card.
For Immigrants (including asylees and parolees)
▪
▪
▪
A complete medical examination including immunizations* is required.
The exam must be completed by a civil surgeon (a physician officially designated by U.S. Citizenship and Immigration Services or USCIS)
or their designee.
The USCIS Form I-693 is used for this exam and must be signed by the civil surgeon.
For Refugees
▪
▪
▪
For refugees who arrived to the U.S. without a Class A condition, only immunizations* need to be reviewed and updated.
For refugees who arrived to the U.S. with a Class A condition, the entire medical exam is required, including any necessary vaccinations.
Refugees must meet vaccination requirements according to age-appropriate recommendations by the Advisory Committee for
Immunization Practices (ACIP). Because completion of a vaccine series often requires several months, applicants are required to
complete at least one dose of each vaccine by the time of assessment for the I-693, and are encouraged to follow up with a primary
health care provider to complete the series.
(June 2017) Page 1 of 7
MINNESOTA CIVIL SURGEONS LIST
▪
▪
The USCIS Form I-693 is used to record immunizations and must be signed by the civil surgeon or by a physician affiliated with the local
public health agency completing the review. Use the most current form; go to www.uscis.gov/portal/site/uscis, search Form Number for
I-693 under the Forms sub-header.
All refugees who are applying for adjustment of status and only need to submit the vaccination record should submit the entire Form I693, but only need to complete the following sections:
▪ Part 1: Information about you
▪ Part 2: Interpreter contact information, certification, and signature
▪ Part 4: Civil surgeon’s contact information, certification, and signature
▪ Part 7: Vaccination record
*To avoid high out-of-pocket expenses, refugees and immigrants with insurance should go to their own primary clinic to complete or
update immunizations prior to contacting a civil surgeon. For uninsured refugees, immunizations are usually available at a lower cost at
the local public health agency in the county in which they reside. NOTE: Prices may vary among clinics.
▪
▪
For more information on how to determine if your child can get free or low cost immunizations, see Can My Child Get Free or Low Cost
Shots? (www.health.state.mn.us/divs/idepc/immunize/howpay.html)
For adults (19 years and older), immunizations may be available at low-cost at the local public health agency in the county in which they
reside or in other participating clinics. Search for participating clinics at Vaccination Clinics Serving Uninsured or Underinsured Adults
(www.health.state.mn.us/divs/idepc/immunize/adultvax/clinicsearch.html)
For More Information
▪
▪
▪
▪
Download the complete Form I-693, Report of Medical Examination and Vaccination Record (https://www.uscis.gov/i-693) from the U.S.
Citizenship and Immigration Services
Find a Doctor (https://my.uscis.gov/findadoctor) who is authorized by U.S. Citizenship and Immigration Services
CDC offers guidance on:
▪ Medical Examination of Immigrants and Refugees (www.cdc.gov/immigrantrefugeehealth/exams/medical-examination.html)
▪ Technical Instructions for Vaccination for Civil Surgeons (www.cdc.gov/immigrantrefugeehealth/exams/ti/civil/vaccination-civiltechnical-instructions.html)
▪ Tuberculosis Technical Instructions for Civil Surgeons (www.cdc.gov/immigrantrefugeehealth/pdf/tb-ti-civil.pdf)
Additional guidance is available from the MDH Refugee Health Program at 651-201-5414
(June 2017) Page 2 of 7
MINNESOTA CIVIL SURGEONS LIST
County
Agency
Civil Surgeon
Phone
Dr. Holtan
Dakota County Western
Service Center
14955 Galaxie Ave.
Apple Valley, MN 55124
952-891-7500
MD PHYSICALS, INC.
Dr. Partida-Ruesga
14135 Cedar Ave. #300
Apple Valley, MN 55124
952-431-9655
MIDWAY MEDICAL CLINIC
Dr. Radjenovich
119 30th Ave. W.
Alexandria, MN 56308
320-763-6452
AA PHYSICIANS
Dr. Axelrod
6545 France Ave S.
Ste. #125
Edina, MN 55435
952-846-7446
AM PHYSICIANS
Dr. Mirman
Dr. Bacaner
4201 Excelsior Blvd.
St. Louis Park, MN 55416
952-564-3882
AMERICAN IMMIGRATIONS
OF TWIN CITIES MEDICAL
CLINIC
Dr. Oldenburg
Dr. Green
3264 W. Lake St.
Minneapolis, MN 55416
612-285-9996
DAKOTA COUNTY PUBLIC
HEALTH DEPARTMENT
Dakota
Douglas
Address
Hennepin
Services Offered
▪ Review and process paperwork for
I-693 for refugees, only who live in
Dakota County, including
vaccinations if needed.
▪ Processing takes 2-4 weeks after
required immunizations received.
▪ Must call for an appointment.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ I-693 Medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Same day appointments; call before
coming.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ For vaccination assessment,
paperwork completed same day; all
other paperwork returned within 23 days.
▪ Appointments generally available
within 2 days.
(June 2017) Page 3 of 7
MINNESOTA CIVIL SURGEONS LIST
County
Agency
Civil Surgeon
Address
Phone
Services Offered
BOYNTON HEALTH SERVICE
Dr. Risdahl
Dr. Park
410 Church St. S.E.
Minneapolis, MN
55455-0346
612-625-3222
CENTRAL AVENUE CLINIC NEIGHBORHOOD
HEALTHSOURCE
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Practice is limited to University of
Minnesota students, faculty, staff
and their dependents 12 years of
age and older.
Dr. Price-Isuk
2610 Central Ave. N.E.
Minneapolis, MN 55418
612-781-6816
▪ Full I-693 medical exam
612-871-2644
763-566-8700
▪ Full I-693 medical exam.
▪ Review and process paperwork for
I-693 for refugees, including
vaccination if needed.
▪ Walk-ins accepted before 4 p.m.
CROWN MEDICAL CENTER
100 East Franklin Ave. South
Minneapolis, MN 55403
Dr. Onyekaba
Dr. Nguyen
1925 First Ave. S.
Minneapolis, MN 55403
6901 78th Ave. N.
Ste. 103, Section B
Brooklyn Park, MN 55445
Hennepin
COMMUNITY-UNIVERSITY
HEALTH CARE CENTER
(CUHCC)
Dr. Reif
Dr. Borowsky
2001 Bloomington Ave.
Minneapolis, MN 55404
612-638-0700
FREMONT CLINICNEIGHBORHOOD
HEALTHSOURCE
Dr. Vint
3300 Freemont Ave. N.
Minneapolis, MN 55412
612-588-9411
HENNEPIN COUNTY PUBLIC
HEALTH CLINIC
Dr. Tsukayama
525 Portland Ave.
Minneapolis, MN 55415
612-543-5555
HENNEPIN COUNTY
MEDICAL CENTER
PEDIATRICS
Dr. Maroushek
701 Park Ave.
Minneapolis, MN 55415
612-873-6963
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccination if needed.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccination if needed.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Full I-693 medical exam only
▪ Pediatric patients younger than 19
years old only.
(June 2017) Page 4 of 7
MINNESOTA CIVIL SURGEONS LIST
County
Civil Surgeon
Address
DR. AKBAR SAJADY
Dr. Sajady
4400 Oliver Ave. N.
Minneapolis, MN 55412
612-522-3391
SHERIDAN NEIGHBORHOOD
HEALTHSOURCE
Dr. Benzie
Dr. Bresette
342 13th Ave. N.E.
Minneapolis, MN 55413
612-362-4111
V KARE CLINIC
Dr. Hussain
763-323-6564
▪ Full I-693 medical exam only
Kandiyohi
AFFILIATED COMMUNITY
MEDICAL
CENTERS/WILLMAR
11209 Commerce Drive N.
Champlin, MN 55316
Dr. Mellema
1010 Willmar Ave. S.W.
Willmar, MN 56201
320-231-5029
Koochiching
RAINY LAKE MEDICAL
CENTER
Dr. Helleloid
2501 Keenan Drive
International Falls, MN
56649
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
218-283-9431
▪ I-693 medical exams available on
Tuesdays.
Lyon
AFFILIATED COMMUNITY
MEDICAL
CENTERS/MARSHALL
Dr. Kremer
Dr. Odland
1420 E. College Drive
Marshall, MN 56258
507-532-1114
Nobles
AVERA WORTHINGTON
SPECIALTY CLINICS
Dr. Clark
1216 Ryans Road
Worthington, MN 56187
507-372-2921
Nobles
SANFORD CLINIC
WORTHINGTON
Dr. Patel
1680 Diagonal Road
Worthington, MN 56187
507-372-3800
MAYO CLINIC
Dr. Cowl
Dr. Hagen
Dr. Molella
Dr. Buchta
200 First St.
Rochester, MN 55904
507-284-4251
▪ Full I-693 medical exam
OLMSTED PUBLIC HEALTH
Dr. Trippel
Dr. Molella
2100 Campus Drive S.E.
Ste. 100
Rochester, MN 55904
507-328-7500
▪ Full I-693 medical exam
Hennepin
Agency
Olmsted
Phone
Services Offered
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccination if needed.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Full I-693 medical exam
▪ Appointments coordinated through
R. Bankston with Nobles County at
507-295-5368.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
(June 2017) Page 5 of 7
MINNESOTA CIVIL SURGEONS LIST
County
Agency
Civil Surgeon
Address
Dr. Morales
393 N Dunlap St. LL34
St. Paul, MN 55104
651-644-6002
Dr. Nomo-Ongolo
Silver Lake Plaza Building
4001 Stinson Blvd. N.E.
Ste. LL32
St. Anthony, MN 55421
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
612-788-2273
▪ Full I-693 medical exam
▪ Call to schedule exam and
assessment of immunization needs.
EZY URGENT CARE
Dr. Perelman
1001 Jahnson Parkway
St. Paul, MN 55106
651-646-0028
GILLETTE CHILDREN'S
SPECIALTY HEALTHCARE
(Phalen Lifetime Clinic)
Dr. Meininger
200 University Ave. E.
St. Paul, MN 55101
651-290-8707
HEALTHEAST ROSELAWN
CLINIC
Dr. Letts
Dr. Jewett
Dr. Stanton
1983 Sloan Place
Ste. 1
St. Paul, MN 55117
651-326-5700
MINNESOTA
OCCUPATIONAL HEALTH
Dr. Kipp
ST. PAUL FAMILY MEDICAL
CENTER
Dr. Xiong
WESTSIDE COMMUNITY
HEALTH SERVICES
Dr. Benfield
Dr. Nesvig
CENTRAL MEDICAL CLINIC
COMPLETE HOME HEALTH
SERVICES
Ramsey
1661 St. Anthony Ave.
2nd Floor
St. Paul, MN 55104
1239 Payne Ave.
St. Paul, MN 55130
153 Cesar Chavez St.
St. Paul, MN 55107
Phone
Services Offered
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Patients with childhood onset
disabilities only.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
▪ Must bring proof of vaccinations as
clinic does not provide
immunizations. Clinic accepts
insurance.
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
651-968-5300
▪ Full I-693 medical exam
651-209-8350
▪ Full I-693 medical exam
651-222-1816
▪ Full I-693 medical exam
▪ Review and process paperwork for
I-693 for refugees, including
vaccinations if needed.
(June 2017) Page 6 of 7
MINNESOTA CIVIL SURGEONS LIST
County
Agency
Civil Surgeon
Roseau
ALTRU HEALTH SYSTEM
Dr. Anderson
HEALTHEAST STILLWATER
CLINIC
Dr. Restad
STILLWATER MEDICAL
GROUP
Dr. Hipp
Washington
Address
711 Delmore Drive
Roseau, MN 56751
2900 Curve Crest Blvd.
Stillwater, MN 55082
1500 Curve Crest Blvd.
Stillwater, MN 55082
Phone
Services Offered
218-463-1365
▪ Full I-693 medical exam
651-471-5600
▪ Full I-693 medical exam
651-275-3330
▪ Review and process paperwork for
I-693 for refugees, including
vaccination if needed.
Minnesota Department of Health
Refugee and International Health Program
PO Box 64975
St. Paul, MN 55164-0975
651-201-5414 or 1-877-676-5414
www.health.state.mn.us/refugee
(June 2017) Page 7 of 7